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An Inahbitual Etiology of Acute Intestinal Obstruction: The giant fecalome

Surgical Science 2023年第3期14卷 225-230页

作者： Leh Bi Kalou Ismaèl Traoré Mamadou N’Dri Ahou Bernadette Ekra Amos Serge Akowendo Ezéchiel Kouakou Blaise Amos Bamba Inza Kouakou Kouamé Bernadin Anzoua Kouakou Ibrahim Lebeau Roger Diané Bamourou Department of General and Digestive Surgery CHU of Bouaké Bouake Ivory Coast

The authors report an observation of a 20-year-old patient, who was referred by the medical emergency department for abdominal distention. The disease would have started with the appearance of abdominal pain, a stop of materials without stopping gases appeared gradually and evolving for 4 months. The patient was chronically constipated. She administered daily enemas with homemade products to have a bowel movement. She never had rectal bleeding, there was no alteration diarrhea—constipation. Mother of 3 children alive and apparently healthy. On clinical examination the abdomen was enlarged in size, painless but of firm consistency. The hernial orifices were free. Hard and abundant stools were noted on digital rectal examination. The abdominal CT scan revealed a large endorectal fecal impaction going up into the left colon, an absence of abdominal mass. We retained the diagnosis of giant fecal impaction. The patient was hospitalized and we instituted paraffin oil therapy combined with an evacuator enema with glycerin. The evolution was marked by a resumption of transit in the form of stool and gas (3 to 4 stools per day). At Day 8 of hospitalization the abdomen had decreased in volume the transit was regular and the patient was discharged on Day 10. Reviewed 3 months later, she maintained a regular transit made of one bowel movement a day. After a setback of 3 years the transit is still preserved. The authors discuss the etiologies of fecal impaction and their respective treatments.

关键词： Intestinal Obstruction giant fecal impaction

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